Does anything work in sex education?

Abstinence education doesn’t work. That was the big hoopla in the American press over the publication of a study by Mathematica, purporting to show that abstinence education programmes don’t work. But with a bit of checking, I found something you are not likely to hear on the evening news. Sex education programmes don’t “work” either. [1]

Let me give a bit of background, for the benefit of readers not immersed in US politics over the funding of sex programmes. The federal government began funding abstinence education programmes in 1998. This, after many years and millions of dollars spent funding programmes that teach contraception as a neutral technology that fourth graders can choose to use or not as their wisdom decrees. In the last election, the Democrats took control of Congress. Given their record on moral issues, it is likely they will reduce or eliminate the funding for abstinence education. Their move will be to fund only “comprehensive sex education,” which in practice means programmes that teach contraception first, sexual activity as an entitlement and abstinence as an afterthought.

If those are the alternatives, it is fair to ask whether sex-ed programmes any more successful than abstinence programmes. Let’s listen to some experts.

A 2002 study published in the British Medical Journal examined 26 programmes that included school based programmes, multi-faceted programmes, family planning and clinic based programmes, as well as abstinence programmes in the US and Canada. The results: “The interventions did not delay initiation of sexual intercourse in young women or young men, did not improve the use of birth control at every intercourse, or at last intercourse for either men or women, did not reduce pregnancy rates in young women.”[2]

Another study of a very well-designed and well-delivered sex-ed programme in Scotland was also published in the BMJ. The result: “When the intervention group was compared with the conventional sex education group, there were no differences in sexual activity or sexual risk taking by the age of 16 years.”[3]

Then there is Douglas Kirby’s 2001 survey of over 300 programmes of all sorts. “Most studies of school-based and school-linked health centers revealed no effect on student sexual behavior or contraceptive use.”[4]

Finding programmes that don’t work is not very difficult. Programmes based in schools, whether of the sex-ed or abstinence variety, do not work very well at reducing teen pregnancy. Adults coming into the classroom and yammering about sex, whether for it or agin’ it, just do not have much impact on teens.

When you think about it, this is not surprising. We know from other kinds of studies that the biggest protective factors for delaying teen sex are married parents and religious observance. Some of the sex-ed studies confirm this by showing that within their little samples, family composition, parental supervision, parental expectations for behavior are among the biggest protective factors. In other words, what is going on at home completely dwarfs anything that is going on at school. As Dr Trevor Stammers, a wise British commentator put it: “Much teenage sex has little do with sex itself, but is connected with searching for meaning, identity and belonging.”[5]

That is why some of the more successful programmes include substantial after school and community-based components. The Best Friends abstinence programme, for instance, is not a classroom-based curriculum. It promotes abstinence among teens from inner-city school districts by fostering self-respect and sound decision-making. It includes mentoring for at least 45 minutes a week, group discussions every three weeks, role model presentation, and enrollment in fitness and dance classes. It has had great success at reducing teen pregnancy both at the middle school and high school levels.[6]

Some successful programmes don’t even talk about sex. Douglas Kirby again: “One group of effective programs were service learning programs. These programs include voluntary or unpaid service in the community (eg, tutoring, working as a teachers’ aide or working in nursing homes) and structured time for preparation and reflection before, during and after service, (e.g. group discussions, journal writing or papers). ...(S)tudies, have consistently indicated that service learning either delays sexual activity or reduces teenage pregnancy. However, not all service learning programs addressed sexual or contraceptive behavior. Why then did they change behavior? ...

"There are many plausible explanations. The programs may in fact have increased connectedness to caring adults (some of whom may have expressed clear norms about avoiding sex)...they may increased autonomy, or they may simply have occupied a fair amount of discretionary time during which the students might have otherwise been unsupervised at home and might have engaged in unprotected sex.”

If it is possible to reduce teen pregnancy without even discussing sex, I am not particularly troubled about a report on just four abstinence programmes which have already been superseded by other, more sophisticated programmes. Even the Mathematica study does not denigrate abstinence programmes, but instead emphasises: “Some policymakers and health educators have questioned whether the Title V, Section 510 programs’ focus on abstinence elevates STD risks. Findings from this study suggest that this is not the case, as program youth are no more likely to engage in unprotected sex than their control group counterparts.”

The real questions about abstinence education are these. Given that family structure and religious practice are significant protective factors against teen sexual activity, shouldn’t the federal government support marriage and religion? Given that many, many sex-ed programmes do nothing to reduce teen pregnancy, why are we even considering pouring more federal money into Planned Parenthood-type organizations to promote their ideology of human sexuality? And if we are going to pump money into sex-ed programmes of dubious value -- and even more dubious values -- why isn’t it a slam dunk that we should fund abstinence programmes at an equal level?

Of course, there is one other possibility. Given that human connectedness is what kids seek in sex, the federal government could stop spending any money at all on sending ladies into classrooms to hector the kids about sex. We could leave this very human problem to the states, localities, or school boards.